Critically Appraised Topics (CAT)Copyright (c) 2018 University of New England All rights reserved.https://dune.une.edu/pt_studcat
Recent documents in Critically Appraised Topics (CAT)en-usFri, 16 Nov 2018 00:41:08 PST3600Critical Appraisal Of The Efficacy Of Various Assessment Tools In Determining Fall Risk In The Elderly Individual With Parkinson Diseasehttps://dune.une.edu/pt_studcat/11
https://dune.une.edu/pt_studcat/11Thu, 22 Jan 2015 05:06:52 PSTGabriella GoshtigianGraston Soft Tissue Mobilization And Dynamic Balance Training Effects On Pain And Dynamic Postural Control Of Young Athletes With Chronic Ankle Instabilityhttps://dune.une.edu/pt_studcat/10
https://dune.une.edu/pt_studcat/10Tue, 20 Jan 2015 09:45:46 PST
A review of a randomized single-blind controlled trial by Schaefer and Sandrey was done to determine the effects of Graston soft tissue mobilization (GISTM) and dynamic balance training (DBT) on dynamic postural control of young athletes with chronic ankle instability (CAI). Three intervention groups were utilized in this study. The first group interventions consisted of dynamic balance training and Graston instrument-assisted soft-tissue mobilization (DBT/GISTM). The second group interventions consisted of dynamic balance training and Graston instrument-assisted soft-tissue mobilization sham (DBT/GISTM-S). The third group intervention was dynamic balance training as a control group (DBT/C). Based on the following outcome measures: Foot and Ankle Ability Measure (FAAM), activities of daily living (ADL), FAAM Sport, visual analog scale (VAS), and Star Excursion Balance Test (SEBT); all three intervention groups had statistically significant improvements from pre to post-assessments. All intervention groups exceeded the minimal detectable change/minimally clinical important difference for all outcome measures with the exception of the VAS. This article supports the use of GISTM and DBT when treating high school and collegiate athletes with CAI. This study does not provide clinicians with knowledge of the effects of GISTM alone on CAI. Limitations of the study include convenient sampling, single blind controlled trial, and short treatment duration (4 weeks) with no long term follow-up.
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Brandie SchmiererThe Usefulness of Transcutaneous Electrical Nerve Stimulation for the Management of Chronic Low Back Painhttps://dune.une.edu/pt_studcat/9
https://dune.une.edu/pt_studcat/9Tue, 20 Jan 2015 09:40:52 PST
An appraisal was made on a systematic review by Khadilkar et al, which compared the use of transcutaneous electrical nerve stimulation (TENS) against a placebo in the management of chronic low back pain in healthy adults. When comparing TENS versus the placebo, outcome measurements included: pain, functional status, general health status, disability, patient satisfaction and side effects. Per the Visual Analog Scale, two of the three studies were found to have clinically insignificant and clinically unimportant benefits with the use of TENS. Using both the Oswestry Disability Index and Roland-Morris Disability Questionnaire, two studies revealed no statistically significant or clinical importance with the use of TENS for functional status. Both general health status and work status are still under debate based on the limited number of studies. This systematic review does not favor the use of TENS over a placebo for management of chronic low back pain in healthy adults. The small number of eligible trials, the inconsistency associated with the outcome measurements reported and short treatment time may limit this study.
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Nicholas LaSarsoThe Responsiveness Of The Quick DASH Versus The full DASH In Patients With Hand Pathologieshttps://dune.une.edu/pt_studcat/8
https://dune.une.edu/pt_studcat/8Tue, 20 Jan 2015 09:37:13 PSTErika DerksThe Effect Of Anterior Versus Posterior Glide Joint Mobilization On External Rotation Range Of Motion In Patients With Shoulder Adhesive Capsulitishttps://dune.une.edu/pt_studcat/7
https://dune.une.edu/pt_studcat/7Tue, 20 Jan 2015 09:34:25 PSTErika DerksUse Of The Slump Test Over The Straight Leg Raise Test For Diagnosing Lumbar Disc Herniations In Physical Therapy Initial Evaluationshttps://dune.une.edu/pt_studcat/6
https://dune.une.edu/pt_studcat/6Tue, 20 Jan 2015 09:06:57 PST
An appraisal was made on a prospective case-control study by Majlesi J, Togay H, Unalan H, and Toprak S, which determined the sensitivity and specificity of the Slump Test and Straight Leg Raise Test. Results of these tests were compared to the MRI results of the 75 patients involved in this study. Per Epi Info 2000, the Slump Test had higher levels of sensitivity and specificity compared to the Straight Leg Raise Test. The Slump Test had sensitivity and specificity levels of 84% and 89%, respectively. In comparison, the Straight Leg Raise Test had sensitivity and specificity levels of 52% and 83%, respectively. Although the Straight Leg Raise Test is sometime taught as the gold standard for ruling-in lumbar disc herniations, the results of this study indicate that the Slump Test may be a more accurate tool. This article supports the use of the Slump Test over the Straight Leg Raise in diagnosing lumbar disc herniations. The study assumes the MRI results are infallible, which may influence the results of this study in the case of misinterpreted MRI results.
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Clinton T. BooneIs The Berg Balance Assessment A Reliable Predictor Of Fall Risk In Older Adults?https://dune.une.edu/pt_studcat/5
https://dune.une.edu/pt_studcat/5Tue, 20 Jan 2015 09:03:32 PST
Bogle Thorbahn and Newton performed a prospective cohort study to determine if the Berg Balance Assessment was a reliable measure at predicting an elderly patient’s fall risk. According to the evidence, the Berg Balance Assessment had low sensitivity for identifying those who would fall, but was highly specific at correctly identifying individuals without a history of falls. In addition, the Berg Balance Assessment proved useful at predicting a person’s use of an assistive device with a sensitivity of 76% and specificity of 94%. The authors concluded that falls are multi-factorial and individuals should be assessed in the environment in which they operate in order to fully determine if a person is at risk for falling. The evidence did not support the use of the Berg to identify fallers, as shown by the low sensitivity; however, did support the use of the test to rule out individuals as non-fallers. The sole use of self-report measures to report fall history and the use of a convenience sample may be limitations of the study.
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Paige BlascoUsing The 6-Minute Walk Test As A Way To Measure Endurance Improvements In Older Individualshttps://dune.une.edu/pt_studcat/4
https://dune.une.edu/pt_studcat/4Tue, 20 Jan 2015 08:59:00 PST
An appraisal was made on a randomized controlled trial by Rikli, R & Jones, C to determine if the 6-Minute Walk Test (6MWT) is a valid outcome measure to determine physical endurance in generally health, older individuals. The participants’ 6MWT results were compared to measures previously proven to be valid and reliable (treadmill testing, composite physical function scale, and self-reported physical activity levels. All data gathered fell within the 95% confidence intervals. The 6MWT was able to distinguish differences between age and fitness level groups, and was comparable to the Balke graded exercise treadmill test. This test has good test-retest reliability as well. One thing to consider is that there should be a trial given before the actual test, as there was always an increase between trials 1 and 2, and a plateau between trials 2 and 3.
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Cory MarcouxImproving Gait And Function In Children With Cerebral Palsy; A Comparison Of Supported Speed Treadmill Training To Therapeutic Exercisehttps://dune.une.edu/pt_studcat/3
https://dune.une.edu/pt_studcat/3Tue, 07 Oct 2014 06:52:40 PDT
An appraisal was made of an article by Schindl et al, regarding the efficacy of supported speed treadmill training (SSTTEP) in children with cerebral palsy (CP). The selected paper included children with GMFCS Level II-IV spastic CP, and compared SSTTEP intervention to therapeutic exercise.

Both intervention groups significantly improved gait speed, cadence, and Pediatric Outcomes Data Collection Instrument (PODCI) global scores, however only the SSTTEP group maintained those gains four weeks after the study ended. The SSTTEP group also yielded decreased stride length.

The study is optimistic for both SSTTEP and therapeutic exercise interventions for improving gait in children with spastic CP.

Using Wainner’s Criteria to indicate a positive ULTT1, calculated sensitivity was 0.9167 and specificity was 0.150. In limiting criteria for a positive test by requiring provocation of 1st-3rd digits only, the sensitivity decreased to 0.5417, however specificity increased to 0.70.

This study was effective in defining the inclusion criteria for denoting a positive versus negative score when using the ULTT1.

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Brianna PalmerTreatment For Cervicobrachial Pain Syndrome; A Comparison Of Direct And Indirect Manual Therapieshttps://dune.une.edu/pt_studcat/1
https://dune.une.edu/pt_studcat/1Fri, 03 Oct 2014 13:01:28 PDT
An appraisal was made on a randomized controlled trial by Allison et al, which compared direct and indirect manual therapies for treating cervicobrachial pain syndrome. The direct therapy group (NT) received neural mobilizations, and the indirect therapy group (AT) received joint mobilizations for the glenohumeral joint and thoracic spine.

Per the Northwick Park Questionnaire and the Short Form-McGill Pain Questionnaire, decreases in pain were statistically significant for both groups from pre-assessment to post-assessment, but not between groups. When using the Visual Analog Scale, a statistically significant improvement was found for both groups over the treatment period, though only the NT group had significantly lower scores at 8 weeks.

This article offers support for both groups in treating cervicobrachial pain syndrome, however a direct approach may be advantageous. Small sample size may limit results of this study.